Prevalence and predictors of help-seeking steps in a nationally representative Dutch sample of romantic couples.

Couples appear to frequently experience relationship problems, yet estimates of the prevalence and prediction of three distinct help-seeking steps, (1) recognition of serious relationship dissatisfaction, (2) considering help, and (3) receiving relationship help, are unknown for representative population samples. This is unfortunate as such knowledge may inform policy makers in the development of strategies to motivate couples to seek help. The prevalence of these steps along with reasons for not acquiring help was studied in a representative population sample of 1014 Dutch heterosexual couples.

Effectiveness and feasibility of structured emotionally focused family therapy for parents and adolescents: Protocol of a within-subjects pilot study.

Mental health issues are widespread among children and adolescents worldwide. Although mental health difficulties may manifest themselves in many different diagnoses, there is growing support for a limited number of underlying transdiagnostic processes. Attachment encompasses a key transdiagnostic mechanism, namely emotional regulation.

Do high-risk couples profit more or less from couple relationship education programs than low-risk couples? Room for improvement and vulnerability effects.

In recent years it has been discussed whether high-risk couples benefit more from Couple Relationship Education programs (CREs) than low-risk couples due to larger room for improvement, or profit less due to greater vulnerability. Pertinent response prediction studies yielded inconclusive results. Careful review suggests this may be due to: statistical handling (not disentangling room for improvement and vulnerability effects), time frame analyzed (not disentangling opposing effects during intervention and follow-up), sampling, and selection of risk factors.

Satisfying and stable couple relationships: Attachment similarity across partners can partially buffer the negative effects of attachment insecurity.

Insecure attachment in couples is negatively associated with relationship functioning. Similarity of partner attachment on the other hand might attenuate such relationship outcomes. We tested the opposing insecurity and similarity hypotheses by examining associations of attachment with relationship satisfaction and instability in a representative community sample of couples (N = 1,014).

Seeing the signs: Using the course of residual depressive symptomatology to predict patterns of relapse and recurrence of major depressive disorder.

Background: Major depressive disorder (MDD) is characterized by high relapse/recurrence rates. Predicting individual patients' relapse/recurrence risk has proven hard, possibly due to course heterogeneity among patients. This study aimed to (1) identify homogeneous data-driven subgroups with different patterns of relapse/recurrence and (2) identify associated predictors.

Effectiveness of the 'Hold me Tight' Relationship Enhancement Program in a Self-referred and a Clinician-referred Sample: An Emotionally Focused Couples Therapy-Based Approach.

While evidence-based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program "Hold me Tight" (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT.

Adult attachment predicts the seven-year course of recurrent depression in primary care.

Background: Attachment theory posits that attachment has a persistent, long-term impact on depression. Empirical data on associations between adult attachment and the long-term course of depression is, however, scarce. The present study addresses this omission.

The ten-year course of depression in primary care and long-term effects of psychoeducation, psychiatric consultation and cognitive behavioral therapy.

Background: While the majority of depressed patients are treated in primary care, long-term follow-up data on the naturalistic course of depression and treatment effectiveness in this setting are scarce. This study examined the ten-year course of depression in primary care patients who had participated in a randomized clinical trial aiming at enhancement of depression outcomes.

Methods: Of the original sample (n=267), 166 patients participated in the ten-year follow-up; missingness was random.

Actor and Partner Effects of Attachment on Relationship Satisfaction and Sexual Satisfaction Across the Genders: An APIM Approach.

Previous studies found gender differences in relationship satisfaction and sexuality. We tested gender differences in associations between attachment, a lasting relationship determinant, and two outcomes, relationship and sexual satisfaction. This study improves on earlier research by examining these associations in one Actor-Partner-Interdependence-Model, making direct statistical testing between outcomes possible.

Bidirectionality Between Sleep Symptoms and Core Depressive Symptoms and Their Long-Term Course in Major Depression.

Objective: To investigate the bidirectional dynamic relationship between sleep symptoms and core depressive symptoms and to identify subgroups differing with respect to their course.

Methods: The weekly state of depressive symptoms in depressed primary care patients (N = 267) was assessed retrospectively every 3 months for 3 consecutive years. The bidirectional relationship between sleep and core symptoms was estimated by means of manifest Markov modeling.

Associations Between Negative and Positive Life Events and the Course of Depression: A Detailed Repeated-Assessments Study.

Although the effects of life events on the onset of depression are well documented, little is known regarding their effects on the course of symptoms in depressed persons. We prospectively examined the associations between negative and positive life events and the course of depressive symptomatology in depressed primary care patients. A total of 267 depressed patients were followed for 3 years using a repeated-assessments design consisting of 36 monthly assessments of the 9 Diagnostic and Statistical Manual of Mental Disorders depression symptoms and positive and negative life events.

Predicting long-term depression outcome using a three-mode principal component model for depression heterogeneity.

Background: Depression heterogeneity has hampered development of adequate prognostic models. Therefore, more homogeneous clinical entities (e.g.

Major depressive disorder as a nonlinear dynamic system: bimodality in the frequency distribution of depressive symptoms over time.

Background: A defining characteristic of Major Depressive Disorder (MDD) is its episodic course, which might indicate that MDD is a nonlinear dynamic phenomenon with two discrete states. We investigated this hypothesis using the symptom time series of individual patients.

Methods: In 178 primary care patients with MDD, the presence of the nine DSM-IV symptoms of depression was recorded weekly for two years.

Simultaneous Decomposition of Depression Heterogeneity on the Person-, Symptom- and Time-Level: The Use of Three-Mode Principal Component Analysis.

Although heterogeneity of depression hinders research and clinical practice, attempts to reduce it with latent variable models have yielded inconsistent results, probably because these techniques cannot account for all interacting sources of heterogeneity at the same time. Therefore, to simultaneously decompose depression heterogeneity on the person-, symptom and time-level, three-mode Principal Component Analysis (3MPCA) was applied to data of 219 Major Depression patients, who provided Beck Depression Inventory assessments every three months for two years. The resulting person-level components were correlated with external baseline clinical and demographic variables.

Systematic Review and Individual Patient Data Meta-Analysis of Sex Differences in Depression and Prognosis in Persons With Myocardial Infarction: A MINDMAPS Study.

Objective: Using combined individual patient data from prospective studies, we explored sex differences in depression and prognosis post-myocardial infarction (MI) and determined whether disease indices could account for found differences.

Methods: Individual patient data analysis of 10,175 MI patients who completed diagnostic interviews or depression questionnaires from 16 prospective studies from the MINDMAPS study was conducted. Multilevel logistic and Cox regression models were used to determine sex differences in prevalence of depression and sex-specific effects of depression on subsequent outcomes.

Personality modulates the efficacy of treatment in patients with major depressive disorder.

Objective: Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups.

Data-driven course trajectories in primary care patients with major depressive disorder.

Background: The chronic nature of MDD has been acknowledged as one of the key determinants of the burden associated with depression. Unfortunately, so far described prognostic factors have been inconsistent, possibly due to used course outcomes that are often based on arbitrary criteria/cut-offs. Therefore, the aim of the current study was to use data-driven trajectory groups based on closely spaced weekly severity ratings, as outcomes in prognostic research.

Depression treatment after myocardial infarction and long-term risk of subsequent cardiovascular events and mortality: a randomized controlled trial.

Objective: Evaluating the effects of implementing an antidepressant treatment strategy in depressed myocardial infarction (MI)-patients on long-term cardiovascular outcomes and all-cause mortality.

Methods: MI-patients were evaluated for the presence of a diagnosis of post-MI depression at 3, 6, 9 and 12months after hospitalization for MI. A total of 331 depressed MI-patients were randomized to intervention or care-as-usual (CAU).

Self-reported depressive symptoms, diagnosed clinical depression and cardiac morbidity and mortality after myocardial infarction.

Background: Self-reported depressive symptoms and clinical depression after myocardial infarction (MI) are both associated with poor cardiac prognosis. It is important to distinguish between the two when assessing cardiac prognosis, but few studies have done so. The present article evaluates the independent prognostic impact of self-reported depressive symptoms and clinical depression on cardiac outcomes after MI.

Symptom profiles of DSM-IV-defined remission, recovery, relapse, and recurrence of depression: the role of the core symptoms.

Background: Depression outcomes in research and clinical practice are commonly defined by the concepts of remission, recovery, relapse, and recurrence. Despite their widespread use, there has been little empirical examination of these concepts. Therefore, we investigated profiles of individual symptoms during each of these phases of depression.

Partner attachment as a predictor of long-term response to treatment with couples therapy.

Vulnerability factors such as insecure attachment may have a lasting effect on the outcome of couples therapy, even long after discharge from treatment. Given that attachment has never been examined as an outcome predictor for couples therapy in the long term, the authors studied its effect on outcome during and after couples therapy. This prospective study included 71 inpatients participating in group couples therapy who the authors measured at baseline, immediately posttreatment at 2 months, and at 8 and 20 months, regarding two outcomes: problem-solving capacity (using the Interactional Problem Solving Questionnaire) and psychopathology (using the 90-item Symptom Check List).

Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research.

Objective: A meta-analysis of over 25 years of research into the relationship between post-myocardial infarction (MI) depression and cardiac prognosis was conducted to investigate changes in this association over time and to investigate subgroup effects.

Method: A systematic literature search was performed (Medline, Embase and PsycINFO; 1975–2011) without language restrictions. Studies investigating the impact of post-MI depression on cardiovascular outcome, defined as all-cause mortality, cardiac mortality and cardiac events within 24 months after the index MI, were identified.

Cost-effectiveness of a psychoeducational relapse prevention program for depression in primary care.

Background: Major depression is a prevalent mental disorder with a high risk of relapses and recurrences, which are associated with considerable burden for patients and high costs for society. Despite these negative consequences, only few studies have focused on interventions aimed at the prevention of recurrences in primary care patients with depression.

Aims Of The Study: To assess the cost-effectiveness of a psychoeducational prevention program (PEP) aimed at improving the long-term outcome of depression in primary care.

Duration of subsequent episodes and periods of recovery in recurrent major depression.

Background: Little is known about the duration of subsequent depressive episodes and periods of recovery, and much is based on potentially biased retrospective data. We therefore prospectively assessed whether duration of depressive episodes and recoveries is correlated within subjects and across episodes, and whether duration of subsequent depressive episodes and recoveries increases or decreases over time.

Methods: From a sample of 267 depressed primary care patients enrolled in a RCT, we identified 279 depressive episodes and 455 recovery periods during a 3-year follow-up.